Live Blogging from the Paleo Summit VI: Nora Gegaudas

Nora Gedgaudas takes on Paul Jaminet's rationale for including safe starches in the diet. Her arguments boil down to the oft repeated meme that we humans have no dietary need for glucose because we can make all we need. She goes into Paul's arguments for starches from his breast-milk composition, body composition and food reward perspectives. The remainder of the substantative part of the interview is spent trying to find other reasons why many folks start to decline on long term VLC diets. Enter theme I'm seeing parroted by TWICHOOBs in comments about the ever increasing list of low carb bloggers jumping ship: we're all just addicts. With a chuckle (joined by Sean) Nora wonders if methadone is to heroine as "safe starches" are to sugar. You see, we're all addicts now. After that, the remainder of the (way too long) interview is spent hemming and hawing and patronizing to make sure to list areas of agreement with Paul Jaminet and a little fawning from Sean over Nora's knowledge and intellect. If you're pressed for time and inclined to listen at all, you won't miss much after the 40 minute mark.

IMPORTANT ALERT:

I have made no secret of my opinion of Nora Gedgaudas. In my opinion, nobody who misrepresents basic physiology/metabolism in the manner she does should be taken seriously. Coming from the LC community I had heard of her but didn't really bother much because, unlike Gary Taubes, I wasn't constantly being bombarded with the "as Gary Taubes tells us ..." education from various folks in the course of discussions. As I've become immersed more in the paleo world I've discovered that she's a pretty big name and high on the lists of organizers of various paleo meetings such as AHS. Her book is highly regarded in paleo circles. I don't get that because a friend sent me her copy of PBPM so I could see for myself. It's not well organized, referenced in a way that makes it difficult to attribute certain statements she makes to the original source so as to confirm their validity, etc. This all boils down to the following from her website:

4. I feel sleepy or tired after meals or I may crave dessert.

These symptoms are “classic” signs of insulin resistance. This may also be indicative of food sensitivities, or possibly even both. Eating a meal is not supposed to fatigue you or make you sleepy/groggy. Many people think it is natural to feel sleepy after a meal. It is not. Eating is supposed to fuel you, if anything. So why would you be fatigued? Your body tries to take sugar from a meal out of the bloodstream as quickly as possible. The first order of business is to send glucose to your cells for immediate energy. If those cells are insulin resistant, then the sugar has to go somewhere (and energy cannot get into the cell). Your body sends some glucose to storage in the liver and muscle as glycogen. The rest of the glucose (i.e., most of it) goes to the liver to get converted into triglycerides so it can get sent to storage as body fat. Unless you have a very high rate of metabolism (not necessarily a good thing) you are likely to gain unwanted weight. This conversion to fat from sugar is a labor intensive process metabolically and takes a LOT of energy to accomplish. –It takes even more if a lot of fat was eaten at the same meal as the carbohydrates. Since burning the carbs off is priority #1 (and because it is impossible to burn fat AND sugar at the same time), whatever dietary fat is there also must be first converted to sugar before it can be re-converted to triglycerides and finally stored as body fat(“All body fat is made from glucose”—Basic medical Biochemistry). This is a very energy INefficient process and takes an enormous amount of energy to do. Finally, foods to which one is sensitive generate stress and inflammation in the body that may also be fatiguing. Ultimately, one must deal with the insulin resistance to address these symptoms, as well as possibly perform an elimination/provocation diet as a means of determining possible food sensitivities. (See pages 78,88, 99, 105 and 167 in PB-PM).

This is WRONG. Gedgaudas did not backtrack on this when I asked her about it in email. Rather than an hour on safe starches, and what Paul Jaminet supposedly doesn't fully appreciate, understand or misinterprets about less settled topics, I'd like to hear -- for however long it takes -- her explain the basic biochemistry of glucose and fatty acid metabolism.

Recommendation:

I don't think there is any reason to get Nora's take on safe starches in order to decide for yourselves whether or not starches should be a part of your diet. Skip this one.

Running Commentary:

Discusses Paul's breast-milk rationale for glucose citing the lactose content of human milk vs. other mammals. Nora suggest this may be a greater need to store more body fat, babies are pudgie, because we don't have fur. She then cites the Textbook of Basic Neurochemistry that newborns make significant utilization of ketone bodies reading the following quote: "Significant utilization of ketone bodies by the brain is, however, normal in the neonatal period. The newborn infant tends to be hypoglycemic but becomes ketotic when it begins to nurse because of the high fat content of the mother's milk." This is an interesting citation and there's some information that bears going into at a future date. For now I'll include the sentence that follows that quote: "When weaned onto the normal, relatively high-carbohydrate diet, the ketosis and cerebral ketone utilization disappear. Studies have been carried out mainly in the infant rat, but there is evidence that the situation is similar in the human infant." OK, remind me about those rodent studies again ;-)

This prompts Nora to ask:

"if the baby's brain was making use of all this glucose then why are babies in a state of ketosis?"

Note that you cannot dispute there is glucose in the breast-milk and yet they are hypoglycemic according to that study so where does the glucose go? I have more thoughts on this for another day.

Claims that our brains can get up to 85% of our energy from ketones. Cite? If it is the aforementioned citation, then one must look at the context of their discussion on ketone utilization which they describe as passive, and make considerable references to what's going on with prolonged starvation and comatose states. Relevance??

Nora: "We're able to manufacture as much as we need from glycolysis (sic) and gluconeogenesis" -- I include this quote because it is nothing new, but for the "typo". I used the "sic" there because in this one instance I'm willing to give a pass and presume she means glycogenolysis

Next up she discusses Paul's version of Food Reward. Basically Paul says cravings for certain foods are seeking behaviors to meet nutritional needs. Nora says cravings are a sign of addiction. She then repeats her assertion that sugar eating would be to a need to store body fat (because in her own description this is such an efficient way to do so!)

Did you know potatoes are devoid of nutritional value?

How can Paul promote eating post-agricultural foods like potatoes and rice. Someone take away his paleo badge before someone gets hurt!

Nora launches into a somewhat lengthy discussion of gluten sensitivity and how many people find rice is "cross-reactive" with gluten (potatoes too, but mostly they are evil because they are night shades). Oh ... and autoimmunity. This is why I enjoyed O'Bryan's interview so much -- he isn't baffling with BS, he defines and describes what he means by everything. Unfortunately Sean doesn't interrupt and ask Nora about this. Paul went to great lengths to look at this for PHD if memory serves. Hopefully he'll address it on his blog.

One nugget we learn from Nora is why the Asians don't get fat on all that rice. They don't eat a lot of it. They are minimalists who don't overeat (so much for the carbs make you eat more outside of your control stuff) so they are healthy in spite of the fact that they do eat a bit of rice.

Nora had chronic appendicitis and nixing potatoes cured that.

She now launches into hyperbole mode equating gluten sensitivity with a life-threatening condition citing O'Bryan. He referred to how celiacs can't have just a little gluten and those with gluten sensitivity as well. This is not the same as saying that anyone with a gluten sensitivity will even be sensitive to *trace* amounts of gluten. And yet she tries to say that trace whatever in rice could be potentially life-threatening.

Low stomach acid affects 90% of the population -- so much for all those billions Big Pharma is making off of pills to shut down stomach acid production .... These are attributed to stress, low thyroid, zinc or B1 deficiency, drinking too much with meals, and lastly combining starch and protein. Ah well, this is why I now consume oatmeal because I learned in Wheat Belly that it will create sulfuric acid in my tummy.

Did you know that hypoglycemia is only damaging if you are metabolically and unnaturally adapted to a dependence on sugar as your primary source of fuel? Neither did I. But here's the kicker: "or if they have excessively depressed cortisol levels which can excessively depress either glycolysis or gluconeogenesis". There's a lot wrong with this one but there it is again -- glycolysis -- not a miss-speak after all.

Now she launches on the immune system angle and takes a jab at Paul for any assertion that LC diets may suppress the immune system. "I've got news for him, everyone does [has suppressed immunity] these days". Of course LF would be worse than LC, but Nora gives us no reason why other than to cite how drinking sucrose lowers neutrophil phagocytosis for 90% for up to two hours of ingestion. (Ringsdorf, W., Cheraskin, E. and Ramsay R. Sucrose,Neutrophilic Phagocytosis and Resistance to Disease, Dental Survey. 1976;52(12):46_48.) Sigh. Nora herself goes on mini-fasts to dampen any kind of insulin response at all if she's feeling even borderline under the weather.

Discussion of auto-immunity etc.etc.

Jimmy listen up! In a total aside she launches into a discussion of low T that goes something like: low testosterone because testosterone reacts with aromatase in fat cells in the presence of insulin converted it to estrogen ... take T therapy, feel better for a bit, but then it too is converted to still more estrogen in a wicked cycle. Adding insulin is not a good thing.

So ... there's got to be another reason all these people report feeling like crap on an LC diet. It must be something else. Next up on the blame podium is eating too much protein. Protein is turned to sugar so there are all these low carbers who aren't fat burners after all. This, Nora says is not natural because all animals are fat burners. Even cows are because carbs are turned to short chain fatty acids in their bodies. Paul makes this argument too, and I find it one of the more ridiculous ones floating out there. SCFA's are not "burned as fat" like MCT and LCT's. That is, they are not broken down by beta oxidation to release energy. We're note even sure exactly how butyrate is metabolized for energy exactly, but cows are fat-makers, not burners. Those SCFA's mostly become substrates for denovolipogenesis to make body fat for us humans to wallow in!

You might not even be craving the carbs you know. It's all those critters within you that you're starving and killing off that are staging a mutiny!

I got totally turned off when she mentiones the long time heroine addict. Yes folks, you are just a long-term sugar addict if you don't thrive on a VLC diet. A slide in the presentation is created as Nora asks:

are safe starches just another form of methadone for the previously carb addicted?

Snicker snicker, "I don't know" -- Sean joins the chuckles here :( Nora regains composure to adopt a very concerned tone as she discusses her concern. But here we go with another dig:

"I think offering some form of absolution for carb addicts with the term 'safe starches' is going to put a lot of people on a really slippery slope."

OK folks I'm going to wrap this up with one long rambling bullet point because the above is just over the top nonsense. She goes on to say that carb consumption makes no sense from an evolutionary sense and talks about cropolites. Those are fossilized feces as we all know and human cropolites contain no evidence of plant fiber. There are pics of some pretty substantial "dumpers" there, but I can't in my naivete wonder if there's no plant fiber because that's what the bacteria eat/ate? Whatever. So then Nora's voice changes tone and her volume lowers perceptibly. Gone is the confidence and whatnot and now she fears she's offended someone or said too much so she -- in somewhat stuttered fashion -- begins to rattle off a list of agreements with Paul, compliments, qualifications of statements, "I don't pretend to have the final word". She says that "not enough attention is paid to the ways glucose is regulated in the body" {paraphrase} and brings up methadone again as a bandaid. That's some chutzpah from someone who has no clue how glucose is metabolized in the human body. At least Nora doesn't claim to think horizontally, but she pats herself (and Paul) on the back for being outside-the-box thinkers (I'm coming to dislike that phrase) so at least they aren't being too simplistic. Only Paul's argument is too simplistic. But he's a smart guy don't get me wrong. Hem ... haw ... hem ... haw. She wraps up any science with a short disscusion of glycation and saying that our bodies produce ROS too but we wouldn't want to add extra ROS. So too then we don't need to add glucose because we can make all we need.

Sean asks, is there ever a need for starches? This one deserved it's own bullet point. Why yes Sean, athletes, those preparing for triathlons, or the Olympics ... ya know elite athletes who need to keep replenishing their glycogen stores {somebody tell Nora she's got this all wrong, athletes are all going keto these days because fat burning metabolisms especially don't need no stinkin carbs}. But anyway, if you're an elite athlete Nora gives you absolution to eat sweet potatoes and bananas. Those won't do too bad a job on your insulin and you won't have to "pay for it later". Minimize the damage by going Durianrider right before your workout (or after) so you burn it all off. Maybe if you're preggers more carbs too. But then she sounds almost like she got scared -- oooh oh oh but I don't think they are essential. We must always and forever remember that!!! But you ladies, take one for the human team and go ahead and risk potential suicide by insulin for the sake of procreating. It's only for 9 months after all, and we thank you.

I get that Nora is trying to make an evolutionary argument for the "fact" that humans ate no carbs to survive Ice Ages and basically ate fat. The Inuit show us this is how humans thrive but sadly Weston Price never managed to "can" the magic of all that. But if that fails she's happy to convince us that we're all just hopelessly sugar addicted and anyone who doesn't feel good eating this supposed diets of our ancestors is just paying homage to the glucose god at the methadone clinic. Maybe Kruse is onto something and we all just need to construct giant walk in freezers in our homes, and in honor of Nora let's install tanning beds in there too. Hmmm ... I'm even willing to say that an evolutionary argument of the "paleo man ate this or that" variety is pretty weak for both low carb or otherwise. But I think you have to be horribly biased to keep having to find excuses why Okinawans are so long-lived and so many human populations have thrived and multiplied on diets predominated by starch consumption. If the Inuit is all the paleo low carbers have to fixate their fat dreams on, it's getting pretty desperate out there.

So, here I thought one of the things that the Ancestral Health folks were trying to do was to expand paleo to the notion of a "template" and broaden the discussion to traditional cultures and ways of eating as well. Surely the other work of Weston Price did not escape Nora's notice? WAPF-style diets include grains even, which is not to say paleo should necessarily embrace them, but there's evidence of grain consumption far predating the 10K year threshold we so often hear bantied about, and our paleolithic Founding Fathers certainly ate plenty of starches, safe or otherwise. I think Paul would agree that his goal in formulating PHD was to construct the "perfect diet" -- in full knowledge that no diet is best for everyone. But that diet to consist of foods available to us today to optimize health. Not to recreate a paleolithic diet, whatever the heck that was anyway.

As the interview closes out, Sean fawns over Nora (as he did in the introduction). He's mesmerized by her knowledge. Wow that Nora is really smart. Nevermind that she gets the basics of human metabolism so wrong. Nah ... let's all look the other way on that one. Personally I struggle to fathom Nora's popularity even moreso than Jack Kruse's sudden notoriety. Her book is a mediocre read at best, contains numerous blatant errors, and at times more than whiffs of plagiarism. It's gotten a facelift (I have the original) but I really wonder how many of her fans have read it. Many Amazon reviewers found it as difficult to read as I did, some were even more harsh. In the end for me, I can never get past someone claiming that all body fat comes from glucose, and then defending that position when challenged rather than correcting it. It's almost as if she's talking about species from another planet. Chylomicronots maybe? Well ... she has appeared on Coast to Coast with George Noory ...

30 comments:

LOL. I lost all sense of credibility in Nora when she had her "podcast." There are so many points that even in my limited understanding of metobolic functions, endocrine system, and basic organic chemistry where I knew she was off her rocker.My favorite line from her book is where she equates longevity with caloric restriction based off ... wait for it... worms. That's right! Worms!(Okay, she was talking about the absence of a lot of insulin somehow helping the worms live much longer lives through caloric restriction.)

Her meal plans are even more spacey. A duck egg fried in saturated animal fat for breakfast. That's it. Can you say, "uh... where's the rest?"

My favorite of all time happens to be the "no nutritional need for carbohydrates." argument. That one just astounds me. You mean that evolution has gotten it WRONG?

I am more and more becoming disenfranchised with this "movement" because it sounds like a lot of bullshit, plain and simple.

What I have is a bunch of smiling people who are thin, look like they don't have a metabolic problem in the world, talking down to the "little guy" like me, who - by their standards, "made the wrong choices... poor guy!" If I would just buy their book/supplements/neurolingualtranscendism-feedbackthingamajiggy I would be totally good.

Here's the best part - the complete rub. I am diabetic. Type 1 (LADA.) I used VLC to get my numbers back in line after diagnosis. It worked - short term. Then things went off the rails.

I gained almost 30 lbs, on a 80/20 paleo diet. (I DID IT WRONG! LOL) Now, I am BACK on Metformin, and taking my insulin like I am SUPPOSED to, and I am thriving again. On 250+g of CARBS per day.

ACK! I eat WHEAT! SOY! RICE! I am filling myself with FATs from a NON-ESSENTIAL macronutrient.

And I'm losing weight, and my ANXIETY and THYROID symptoms are GONE.

That's why I tire of this shit with LC and Paleo/Primal. They've all drunk the koolaid - but it's turned see. They are all drunk and stupid - and the worst thing about drunk and stupid people is - they don't usually know they are being jackasses. LOL

I sure get tired of the "only world class athletes need carbs" thing, I'm not world class, or even neighborhood class, but I like to have the energy to do some athletic stuff. For once I would like for them to acknowledge "Even a sorry ass athlete like you has a use for carbs."

Okay, I admit I'm guilty of not immediately rejecting folks because of their science (or lack thereof). Look what it took for me to go ballistic on Taubes ... his dickish move with Stephan at AHS11 ;).

I guess I cut folks a lot of slack ... perhaps more than I should. One, I think I treat science like religion. There are folks who hold positions I don't agree with at all (e.g., Nora's position on carbs and protein), but I did find her book interesting in parts and I'm frankly very grateful she turned me on to neurofeedback. So just like I do with my former Promisekeeper, now evangelist brother, I just let the parts I find problematic roll off me (you know water/duck's back). With Jack Kruse, I must admit that while his ability to communicate leaves a lot (a LOT) to be desired, I find the whole idea that the modern environment of essentially no seasons is incompatible with our genetics (or at least for some of us) intriguing.

Two, re mistaking glycolysis for glycogenolysis. I think she knows the difference but got them wrong while speaking (and it's not a shocker she made the same mistake twice ... though not sure why gluconeogenesis is easier to say than glycogenolysis). But I'm also sympathetic because this stuff is complicated and the podcast format seems especially ripe for getting details wrong (ref: Paul Jaminet dinging Mat Lalonde for his "our genome is the same chimps" comment).

Anyways, just thought I'd mention this. I cringe a little bit every time you ding AHS leadership. I suspect it's not that they necessarily endorse all of the positions of everyone involved with the organization or its events, but that like me, they are inviting everyone in the family to the holiday gathering as it were.

I think she is more insidious than Dr. Kruse in some ways because she is very professional seeming. Either way, it is probable she does not have access to the latest research in Coprolites (guess who does!!) and is looking at old open-access papers. A lot of the data in those papers has been reevaluated and found to be invalid. And in fact, the most infamous case was that some "paleolithic human coprolites" turned out to be hyena shit.

I would LOVE to see any data on low stomach acid prevalence in the population. I have been looking for years. I have access to several academic libraries and have never found anything.

Welcome MAS! Far be it for me to try to figure Nora out, but I'm thinking the iodine thing may have something to do with Hashimoto's thyroiditis. There's a TON of discussion over on Paul's blog on how iodine can be counterproductive for thyroid if you have that form of hypo, however, so it's not like he can be pegged into a one size fits all corner by a long shot!

Hey Beth, I'll have more later but was curious ... is there an internet conversation about this chimp thing somewhere? I'm listening to the YouTube now and I quibble more with that only adaptation/epigenetics makes the difference. But we share upwards of 95% of our genome with chimps (see that one a LOT). The xyz% similarities between various species is big for evolution v. creationism.

One other thing that disturbs me most about Nora in terms of Diabetics...

"Did you know that hypoglycemia is only damaging if you are metabolically and unnaturally adapted to a dependence on sugar as your primary source of fuel?"

This one makes me spit bullets. Umm.. tell that to the parents of diabetic children who die in the night from a hypoglycemic reaction - even those that are on low carb. It seems like every week there is another story of a kid (or teen) who succumbs to this.

I once emailed her about recovery from HIIT, and how I was using yogurt with berries, peanut butter, and a splash of chocolate milk for recovery. She actually told me to just eat "food" like eggs or butter (or ghee) after a workout. The problem was a drop in blood sugar, not calories. I found later -0 through an ACTUAL diabetic I trust that a person can have a carb load (hence recovery) with a small amount of insulin so the body of a T1 can actually use the glucose after a workout.

That exchange proved to me that Nora had no freakin idea what she was talking about in Endocrine matters. It always seems like a one size fits all approach with diet with these guys.

I have seen the light - it is only about REAL food. I plan to blog about this this coming friday. I drank the Koolaid, but it has ... turned.

so most of this monologue tries to counter Paul Jaminet's argument, but misses his single, most important[0] point, mucus, and doggedly fixates on what sounded to me like Paul's minor contributing arguments, breast milk composition, allergens/anti-nutrients.

@Melissa "she is more insidious...because she is very professional seeming" yes, I totally agree. I did sit through her AHS presentation (fortunately I sat through Mat Lalonde's too, so hopefully that balanced out the brain cells I probably sacrificed) and did try this one, but was struck by how much was structured around opposition to the Jaminets' position. There's a subtle "well I see this in my practice" and "my patients report X, Y or Z" trying to infer that she knows more that the Jaminets because she deals with actual people rather than dusty theory or actual science. I remember that Leptinmanneeuuuuuuuuurosurgeon!!!!! did the same thing to KGH in that retarded Safe Starch mega-post on LLVLC, accusing of him not knowing about "real world problems" because he "sat in a room looking at films" all day, and basically begged for KGH to school him. Which he did.

The whole thing is very smoke & mirrors, vascillating between "my experience with people" and "well, you know, it's HUGE problem" like this apparent low-stomach acid epidemic for which there are no statistics. If she's referring to the fact that antacid-type substances for GERD & the like are on the Top 10 list of Big Pharma drugs sold globally, that's one thing, but then say that. And of course, state the obvious like the fact your stomach produces acid as parasympathetic response by your body. well, duh. but I guess sounds sufficiently sciencey. As Sanjeev noted, it's like Star Trek. Here, the script goes something like: blah blah blah ketones blah blah blah Ice Age blah blah blah parasympathetic blah blah blah starches...safe?! hehehehe blah blah blah gluco..gly....glyco...Geico...lizards...um no..glycolyneolygene#mfjsngomjmmmm.... [[tech]]

"state of ketosis" is ill-defined, and NG doesn't seem inclined to verifiable specificity.

"ketosis" - ketones in the urine (ketonuria) may not mean any ketones are are left the blood by the time you unrinate to measure the ketone concentration.

ketones in exhaled gas is probably a much closer-to-source measurement, but what's being measured, exactly? temporary liver stress response? normal liver function in response to low carbohydrate? Excessive adrenaline/epinephrine? muscular fatty acid use? One of my first experiences with "ketosis" was using the keto stix after a 40k bike ride. The sticks stayed deep purple for 3 days. But the day after the ride I had to go to a company social thing and had some pasta. According to Atkins dogma the stix should have immediately stopped turning colour, but like I just wrote - they kept going deep purple for 3 days, pink for several days after that.

We've gone from the days I used to argue with vegetarians, Ornishians, Pritikinarians and other grain proponents who proclaimed ketonuria equals impending death to Taubesians et al who argue that "ketosis" is the "preferred" human state.

A pox on both their houses (and farmlands and slaughterhouses), sez I.

> My kids used to have that ketosis sort of smell

from memory, there's a bunch of carboxylic acids that can smell close to the acetone based[0] aldehydes that are "ketones", and since the carboxyl smell is so much stronger, it takes much less to produce a similar level of odour.

> Am I missing something?

The fact that you'll never get a straight answer ; )

[0] the names are based on the acetone part, I've forgotten if biological production mirrors the nomenclature.

Welcome Leighan! I still believe low carb can be a valuable part of a weight loss diet, so I don't want to come off anti-LC here either. I'm all about doing something for the right reasons -- this way if it's not working for you, you save yourself time, money and just mental frustration energy. Enjoy your raw milk!

I looked into the baby ketones thing a long time ago. It's mostly rat studies. But there was an interesting wrinkle. Neonates have leaky guts and drink a lot of lactate, the lactate could be converted (in the rats) into acetoacetate. I think. In any event it was a rather cool mechanism but wouldn't apply after 6 months of age, obviously.